Riise-Elnes A.1, Brosstad F.1, 2, Kalikstad B.1,3
1 Medical Faculty, University of Oslo, Norway2 Medical Department, Rikshospitalet-Radiumhospitalet HF, Oslo3 Department of Paediatrics, Rikshospitalet-Radiumhospitalet HF, Oslo
Introduction: Neonatal stroke includes both cerebral infarction and haemorrhage. Maternal or fetal disorders may play a role in the pathogenesis, such as hereditary thrombophilia.
Purpose: To assess the long-term outcome among a Norwegian cohort of children who had suffered neonatal stroke, and to investigate risk factors for thrombophilia.
Method: 50 children born at term with a birth weight >2500 gram were included. Consent from the regional ethical committee to examine and collect blood samples from children and their mothers as well as permission to store the samples in a Biobank at the Coagulation lab at Rikshospitalet, were ready before initiating the study. All parents received information about the investigation, such as neurological examination of the child and questions to the mothers on their impression of their child s level of function as well as blood samples from the mother and the child to test for APC-resistance, protein C, protein S, antithrombin mutation and lipoprotein(a).
Results: 33/50(66,0%) attended whereas 31/50(62,0%) children were assessed by neurological examination. 5/31(16,1%) children had severe gross motoric disorder with quadriplegia or diplegia, and a further 6/31(19,4%) had neuromotoric abnormalities, such as asymmetry or reduced motoric precision. 20/31(64,5%) had a normal motoric outcome. In 5/33(15,2%) families either mother or child or both had FV Leiden mutation, 2/33(6,1%) children had low levels of protein C, and 1/33(3,0%) mother had low levels of protein S.
Conclusions: Our results suggest that although diplegia and quadriplegia occurs in a relatively small proportion of children with neonatal stroke, other symptoms and signs such as motoric and cognitive impairment are present, which often may give rise to concern for the parents. Therefore, we suggest a closer follow-up program for these children to detect those at need for special attention before starting school.